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Aesthetic Dentistry

Whatdoes  aesthetic dentistry represent?

Cosmetic / aesthetic dentistry is today a synonym of modern dentistry, combining art and science together. The modern materials and technology, enable extremely precise and aesthetic restorations regardless the amplitude of the necessary intervention, but we have to keep in mind that oral health and optimal function of the dento-maxillary apparatus must be a priority in any type of treatment. The patients will always seek to solve their dental problems, but will also demand an harmonious appearance that will not betray the presence of prosthetic restorations. Nobody wants anymore metal gray or gold dental restorations, and the new technology can successfully meet the aesthetic requirements of today. But remember, dental aesthetics involves a thorough evaluation of each case, because long-term success of the beautiful result obtained depends on the health and optimal functioning of the whole system (teeth, bite, facial muscles and temporo-mandibular joint).

 Aesthetic analysis must consider:

  • Teeth colour and shape
  • Dental position, crowding or spacing
  • Gingival contour appearance
  • Smile symmetry
  • Face shape

Aesthetic dentistry at Indent

Aesthetic dentistry involves a series of treatments (prosthetics, orthodontics, implantology, oral surgery) aiming to return the natural smile to the patients, enhancing by this their image and self-esteem, and also restoring their overall wellbeing status.

In this respect, Indent offers you:

  • “Smile analysis” and competent advice
  • Bleaching treatment performed both in the clinic (“in-office bleaching”) and at home (“home bleaching”)
  • Aesthetic  composite fillings
  • Minimally invasive porcelain veneers
  • Ceramic inlays
  • Full ceramic crown and bridges ( without metal support)
  • Teeth aligning through orthodontic treatment
  • Aesthetic gum reshaping surgery
  • Application of “tooth jewellery”  without affecting the dental tissues

Dental bleaching

Dental bleaching is a relative simple and rapid way to change dental colour and brightness by using a dental gel based on hydrogen peroxide which is applied on the teeth only after a preliminary professional cleaning treatment. The treatment’s often spectacular result will determine the patients to more often and careful analyse their smile, and also to monitor their dental and gum health for maintaining the neat and attractive result obtained.

 What factors cause tooth discoloration? 

  • Tooth base shade:  tooth colour is genetically established and is 90% determined by dentine colour, the inner layer located under the enamel coating. This is the reason why , the simple professional cleaning (scaling, polishing) only removes the external tooth pigmentation (calculus, stains) from the surface, without having any influence on the inner layer which is actually major influencing the base colour. The bleaching effect depends on the base colour, each tooth reaching a whitening limit above which any supplementary whitening procedure is useless. Best responses to whitening have yellow shaded teeth, the gray shaded ones being the most refractory to treatment.
  • Age: There is a direct correlation between the tooth colour and the age. With age, dentin ( the structure 90% responsible of tooth colour) becomes sclerotique and opaque giving the tooth a dull aspect, darker and without transparency. After the age of 20, the teeth are starting to have a yellowish tint, and so bleaching has very good results. After the age of 40, the yellow tint gets closer and closer to brownish and the tooth becomes more opaque, in which case the treatment gives good results by increasing brightness. The transparency / translucency is the feature that cannot be corrected by any bleaching technique.
  • Eating habits: the usual consumption of red wine, coffee, tea, coca-cola, carrots, oranges and other coloured foods or drinks, are causing in time considerable stains. In addition acid items like citric fruits and vinegar are contributing to the enamel erosion. As a result, the dental surface becomes more transparent and the yellowish dentine stands out.
  • Smoking habit: the nicotine and tar leave brown deposits which are slowly absorbed into the tooth structure.
  • Drugs / chemicals: Use of tetracycline during tooth formation produces intrinsic pigmentation: dark grey or brown striations that are very difficult to remove. Excessive fluoride consumption can cause dental fluorosis characterised by white or brownish pigmentation in extreme cases.
  • Loss of tooth vitality

Which are the tooth bleaching options?

Tooth bleaching can be performed only on perfectly clean teeth (professional cleaning) and it is made with a hydrogen peroxide based gel. Different concentration of peroxide is used according with the bleaching technique used.

In-Office bleaching

The main benefit of this method is a significant change of colour in a short period of time.

This protocol involves first to isolate the gums and then to apply on the dental surfaces bleaching gel with a relatively high peroxide concentration, whose action is potentiated by operating a plasma lamp / dental laser.

In-office bleaching takes around 20-30 minutes according with the system/procedure used. It is a rapid technique, with excellent results, but you must consider that none of the bleaching techniques is sufficient to obtain a lasting effect, colour stabilization is further conditioned by a “home bleaching” system using individual dental trays with a lower concentration gel.

Home bleaching

Many dentists believe that professional home bleaching system can give the best long term results and allow a gradual bleaching controlled by the patient according to his taste.

These easy to use systems are based on low concentration peroxide gel applied in individualised dental trays manufactured by the dental technician. Like this the tray is applied on the dental arch for around 2-3 hours or more (sometimes overnight). Due to the low peroxide concentration, the bleaching gel can stay for longer time without any risk on the dental surface.

Is there a bleaching limit?

It’s all about aesthetics!

The bleaching results can be subjective, varying from one person to another. Many persons are immediately happy with the result while others are disappointed. Before starting any bleaching treatment, it is advisable to ask your dentist to get a realistic idea about the possible result to be obtained and also about how long it takes to obtain that result. Expectations play a major role!

How to maintain the bleaching results?

To maintain on long term the bleaching effects it is advisable to:

  • make once a year a “home bleaching” treatment
  • avoid the consumption of foods and drinks that are staining the teeth, specially for one week after the bleaching treatment
  • maintain an excellent oral hygiene

Attention!

We must consider several factors before using one of the bleaching techniques:

  • Regardless how large is the quantity of bleaching gel you are using it will not help in obtaining beyond natural white teeth
  • The results of the bleaching process will not be fully observed until a 2 weeks period after the treatment. This is an important factor to be taken in consideration when a ceramic based aesthetic restoration is needed and it is desired that the restoration colour should match the colour of the whitened teeth
  • Some old aesthetic fillings should be replaced to match the colour of the whitened teeth (fillings and crowns will not be influenced by the bleaching substances)
  • Due to gingival retraction, in many cases  the root is exposed and it has a more yellowish colour that proved to be hard to bleach
  • Also a waiting period of about 2 weeks after the bleaching treatment is a must before processing any aesthetic composite fillings, due to the residual peroxide which might influence the composite adhesion to the tooth structure.
  • Pregnant or nursing women are advised to delay teeth bleaching

Dental Veneering

Dental veneering is a cosmetic dentistry procedure that can correct minor dental aesthetic problems (colour, shape and in lesser extend frontal teeth inclination) through minimal invasive filing of the visible enamel surface (around 0.3 mm from the superficial dental surface) and the cementation of delicate ceramic veneers (“shells”). The ultimate purpose of dental veneers is to obtain a fully integrated physiognomic restoration, in perfect harmony with the face and gums, keeping in the same time the vitality of the teeth. Due to the fact that the dental preparation and veneers manufacturing involves art and science together, requiring long experience and special technology, the dental veneering treatment is considered the “flagship” among cosmetic dentistry procedures.

Dental veneers can be manufactured in our clinic with CAD / CAM (Cerec) technology or by technician in the dental laboratory.

Which are the advantages of the ceramic veneers?

  • Impeccable aesthetics: texture and transparency similar with natural teeth 
  • Minimal invasive and bio-tolerated: dental veneering involves minor filing of teeth exterior surface (0.3 – 0.5 mm from enamel structure) while maintaining the tooth vitality. Due to both, very high chemical stability and biocompatibility in respect of the gums, dental veneers are perfectly tolerated by the oral cavity tissues. Due to the ceramic veneer’s smooth and glossy surface, the bacterial plaque hardly adheres to it, by this reducing the risk of gum inflammation.
  • Stability in time: dental veneers life is high if patient is properly maintaining them by flawless oral hygiene at home and recalls for professional cleaning in the clinic. Also, it is recommended for the patient to use protection dental trays during sleep to avoid unconscious strain of these delicate reconstructions.

Are there any contraindications in veneering?

Dental veneers are a perfect aesthetic option, but in some cases there are not indicated:

  • Multiple extended caries. Their treatment is done first, and then the situation is reassessed.
  • Active or severe periodontal disease. The periodontal disease is treated first, the hygiene is monitored and only then the situation is reassessed.
  • Extended dental destruction – large fractures, complicated caries or voluminous fillings. In those situations, crowns are more indicated.
  • Insufficient enamel thickness on the tooth facial surface – due to the fact that dental veneers are bonded only on the enamel surface, for those teeth with thin enamel layer (rebated or thinned due to past treatments) this treatment is not indicated.
  • Bruxism (teeth grinding): is a relative contraindication, but wearing protective dental guard in the night is mandatory.